Individual provider Active NPI

Megan Makahanaloa-Antunez

  • Nurse Practitioner
  • Wailuku, HI
National Provider Identifier
1174068571
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2091 Issued in HI
Practice address
221 Mahalani St
Wailuku, HI 96793-2526
Phone
(704) 373-0212
NPI assigned
Dec 21, 2016
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2091 HI Primary

Addresses

Primary practice location

221 Mahalani St
Wailuku, HI 96793-2526

Mailing address

221 Mahalani St
Wailuku, HI 96793-2526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718002782 HI Practitioner - Nurse Practitioner 9638446123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 244-9056

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2091HIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC Current Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince May 6, 2019 Accepting new patients
Maui Health System a Kaiser Foundation Hospitals LLC CurrentSince May 6, 2019 Accepting new patients

Locations

1849 Wili Pa Loop
Wailuku, HI 96793
Phone (808) 242-2010

221 Mahalani St
Wailuku, HI 96793
Phone (808) 242-2290

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1174068571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 MAHALANI ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967932526",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKAHANALOA-ANTUNEZ",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "2091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.